Monday, July 10, 2006

IN MY VIEW: Surgeon General and Anti-Smoking Groups Irresponsible for Not Calling for Ban on Smoking

If one accepts as true the statements that the Surgeon General and more than 80 anti-smoking groups have made about the health risks of brief exposure to secondhand smoke, it is my view that it is irresponsible and inexcusable for these groups not to have called for a ban on smoking.

How can you, as a Surgeon General, truly believe that a brief exposure to secondhand smoke causes heart disease and lung cancer and fail to recommend that this devastating health hazard be eliminated?

How can you, as an anti-smoking group, truly believe that 30 minutes of exposure to secondhand smoke causes people to develop hardening of the arteries and to suffer fatal heart attacks and fail to call for the prohibition of smoking?

To me, that is simply inexcusable. It is a breach of the public's trust. The public has placed in the Surgeon General and in these public health organizations a certain amount of trust that they will make responsible recommendations that are based on the science. And since the science apparently shows that even a brief exposure to drifting tobacco smoke is enough to cause people to drop dead from heart attacks, to develop heart disease, and to come down with lung cancer, there is simply no excuse for allowing any exposure to this hazard.

Let's face it: if these statements are true, then secondhand smoke is the most toxic substance known to man to which there is widespread exposure. There is no other substance I can think of to which people are widely exposed that can kill people after just a brief exposure.

Cyanide is about as hazardous. Even a small amount is enough to kill a person. But this is not a hazard to which people are widely exposed.

Other substances to which people are commonly exposed are clearly not as hazardous. I've never heard of anyone claiming that breathing in car exhaust for a few minutes can cause you to develop heart disease and lung cancer. Radiation is also something to which we are widely exposed. But no one has told me that even a single X-ray causes cancer. Radon in homes is a common exposure. But I've never heard anyone claim that being in a home with radon for just a half hour is enough to put someone at a significantly increased risk of developing lung cancer. Vioxx is (or was) commonly used, and can apparently cause heart disease. But I've never heard any group claim that just a single Vioxx pill can cause heart disease.

In comparison to these other health hazards to which people are commonly exposed, secondhand smoke obviously is in a class by itself. It's the only widespread exposure for which a brief exposure is enough to cause disease and death. Yet the Surgeon General and anti-smoking groups are perfectly content to allow this exposure to take place day in and day out. People are dying in front of them, and they are failing to take action to protect these people.

Truly, it is irresponsible and inexcusable. We, as public health practitioners, cannot just sit back and watch as people die, left and right, because of a widespread toxin that can kill with just a brief exposure. We are breaching our public responsibility and we are betraying the public's trust.

There's only one way out of this quandary. In order to argue that our actions are responsible, we'd have to hold that we don't actually believe that a brief exposure to secondhand smoke is enough to cause heart disease and lung cancer, and to kill healthy people by causing fatal heart attacks.

But if we hold that, then we're lying to the public, because we're telling them something which we don't believe.

One way or the other, the Surgeon General and these anti-smoking groups are betraying the public's trust. If not through deceiving them about the severity of the hazards associated with brief secondhand smoke exposure, then it's through their failure to protect people from a widespread hazard that can cause heart disease after just a brief exposure, making it the most hazardous substance to which people are commonly exposed. Either way, it seems to me that there's no excuse.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.